Air Force Pre-Qualification Form

1
Full Name* This field is required.
First Name
Middle Name
Last Name
2
What is your current age?* This field is required.
3
Do you have a current Driver's License?* This field is required.
YESNO
4
What is your current Height and Weight (in inches and pounds)?* This field is required.
5
Have you EVER been seen by a doctor for ANY REASON other than normal childhood illnesses or have you had issues/experiences with the following: ER visits, Hospitalizations, Surgeries, Counseling other than educational, Allergies, Broken bones, Asthma, Skin rashes, Missing appendages, Mental health disorgers (ADHD, ADD, anxiety, depression, self harm, etc.), Severe scars, Medications, Inhaler use, or any other items in your medical history? If so, please explain for each item below.* This field is required.
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6
Have you EVER been cited, arrested, charged, held or detained by ANY law enforcement agency, to include minor traffic tickets and/or juvenile violations, even if you were told your records would be dropped, dismissed, sealed or expunged? Do you have ANY fines that have not been paid? If so, please explain for each item below.* This field is required.
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7
Which of the following financial situations apply to you? (Please select all that may apply)* This field is required.
Bills in collections
Charge offs
Bankruptcy
Repossessions
Payments overs 60 days late
None of the above
8
Do you have any tattoos? If so, please explain below how many and where they are located.* This field is required.
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Should be Empty: